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Individual

DESIREE BALTAZAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
910 N EAST ST, BENTON, AR 72015-3327
(501) 381-2001
(501) 381-2005
Mailing address
910 N EAST ST, BENTON, AR 72015-3327
(501) 381-2001
(501) 381-2005

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
12109-M
AR
1041C0700X
Clinical Social Worker
Primary
12109-C
AR

Other

Enumeration date
07/12/2022
Last updated
02/06/2025
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